Legal
CVS to Pay $315M Settling Opioid Prescription Claims
The Justice Department announced that CVS Health agreed to pay $315 million to settle allegations that the company illegally filled prescriptions for opioids and other controlled substances. The settlement resolves a lawsuit first filed in 2019 by former CVS employee Hillary Estright under a whistleblower provision. The announcement does not specify the breakdown of federal versus state recoveries or how much, if any, relates specifically to Medicaid-reimbursed prescriptions. CVS operates pharmacy benefit and retail pharmacy services that interact with Medicaid beneficiaries across many states, making controlled-substance dispensing practices relevant to program integrity oversight.
Why it mattersState Medicaid agencies and pharmacy program integrity units should watch whether any portion of the recovery is tied to Medicaid claims, since dispensing-practice settlements of this scale can prompt renewed scrutiny of pharmacy network compliance and controlled-substance utilization controls.
Also covered by:beckershospitalreview.com